DR. FAYYAZ MAHMOOD (MD) – Internal Medicine Physician, NPI 1790777050

DR. FAYYAZ MAHMOOD (MD) is a healthcare provider. based in Gresham, Oregon. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. MD16510 (OR). The NPI Number for DR. FAYYAZ MAHMOOD (MD) is 1790777050

Main info

Male
Accepts Medicare Assignment
Name
DR. FAYYAZ MAHMOOD (MD)
NPI
1790777050
Phone
(503) 674-5818
Address
24988 SE STARK ST
Enumeration Date
22 August 2005
Last Update Date
17 November 2014

Doctor Profile

Medical School Name
NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
null (2026 years ago)
PAC ID
7416146790
Professional Enrollment ID
I20110118001265
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. FAYYAZ MAHMOOD (MD)

  • 24988, Southeast Stark Street, Gresham, Metro, Multnomah County, Oregon, 97030, United States

    STE 300

    GRESHAM, OR 970308322

    Phone: (503) 674-5818

    Fax: (503) 674-6709

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $34.

Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.

Last reported payment date: 2023-05-24 • Largest payer in this snapshot: EMD Serono, Inc. ($34).

Total Amount

$34

General + Research + Ownership

Payments

2

Total payment records

General Amount

$34

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
EMD Serono, Inc.$34
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-01-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110118001265IInternal MedicineORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97030)

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Provider's Procedures

DR. FAYYAZ MAHMOOD (MD) performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEOR83036Hemoglobin A1C level3217

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. FAYYAZ MAHMOOD (MD)?
DR. FAYYAZ MAHMOOD (MD) — NPI 1790777050 — is the standard way to identify this listing.
Is DR. FAYYAZ MAHMOOD (MD) listed as active for patients and plans?
The listing shows DR. FAYYAZ MAHMOOD (MD) as active in the NPI system.
What taxonomy line describes DR. FAYYAZ MAHMOOD (MD)?
For research purposes, treat DR. FAYYAZ MAHMOOD (MD) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. FAYYAZ MAHMOOD (MD) list a practice location?
Patients near Gresham, Oregon may find DR. FAYYAZ MAHMOOD (MD) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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